Abstract: 【Abstract】Objective The risk factors for coronary artery calcification and cardiovascular death in maintenance hemodialysis (MHD) patients in a hemodialysis center were investigated. Methods The primary event (cardiovascular death) and secondary event (coronary artery calcification) were analyzed in a total of 340 MHD patients who were followed up between June 2008 and June 2017. Cox regression models were used to investigate the risk factors for end events. Results The independent risk factors for coronary artery calcification were dialysis vintage (HR=1.218, 95% CI 0.987～1.586, P＜0.001), serum phosphorus level (HR=1.126, 95% CI 0.092～2.638, P=0.005) and intact parathyroid hormone level (HR=1.112, 95% CI 0.806～1.132, P=0.032). A negative correlation was found between the risk of coronary artery calcification and the administration of non-calcium phosphate binder (HR=0.627, 95% CI 0.223～1.164, P=0.037). The independent risk factors for cardiovascular death were age (HR=1.016, 95% CI 0.935～1.062, P=0.014), dialysis vintage (HR=1.233, 95% CI 0.872～1.418, P＜0.001) and serum phosphorus level (HR=1.146, 95% CI 0.898～2.674, P= 0.007). Hemoglobin level was negatively correlated with the risk of cardiovascular death (HR=0.880, 95% CI0.806～1.203, P=0.033). Conclusion The risk for coronary artery calcification increased in MHD patients
with longer dialysis vintage, higher levels of serum phosphorus and intact parathyroid hormone, while decreased in MHD patients using non-calcium phosphate binder. The risk for cardiovascular death increased in MHD patients with older age, longer dialysis vintage, lower hemoglobin and higher serum phosphorus.

Key words: Hemodialysis, Mineral and bone disorder, Coronary artery calcification, Vascular calcification, Non-calcium phosphate binder, Cardiovascular disease